ABSTRACT
CONTEXT: Heterotopic pancreas of the gallbladder is an extremely rare entity, especially when pancreatic tissue appears histologically with an exclusively exocrine structure. CASE REPORT: We report the case of a 35-year-old man who presented with symptoms of acalculous gallbladder disease with high levels of amylasuria. Immunohistochemical analysis of the surgical specimen of the cholecystectomy revealed pancreatic tissue at the gallbladder wall. CONCLUSIONS: Heterotopic pancreatic tissue is a rare pathological finding in the gallbladder. It requires consideration and sensitization in the differential diagnosis of acalculous gallbladder disease, which can explain hyperamylasuria in cases of unknown origin.
Subject(s)
Amylases/urine , Cholecystitis/complications , Choristoma/complications , Gallbladder Diseases/complications , Pancreas , Abdominal Pain/diagnosis , Abdominal Pain/etiology , Abdominal Pain/urine , Adult , Anorexia/diagnosis , Anorexia/etiology , Anorexia/urine , Cholecystitis/diagnosis , Cholecystitis/urine , Choristoma/diagnosis , Choristoma/urine , Chronic Disease , Gallbladder Diseases/diagnosis , Gallbladder Diseases/urine , Humans , Male , Up-RegulationABSTRACT
Specific electrical conductance (SEC) of the hepatic bile in 94 patients with cholelithiasis and concomitant pancreatitis was increased (p < 0.001) and depended on the degree of cholestasis and the morpho-functional state of the liver. The value of SEC of the intraoperative bile higher than 193 S/m is taken for a criterion of the diagnostics of biliary pancreatitis. The electrical conductance of urine during the first 4 days of observation decreased in patients with acute pancreatitis (p < 0.05), impaired carbohydrate metabolism and concomitant renal dysfunction. The value of SEC of urine lower than 238 S/m corresponds to acute pancreatitis. The investigation of physico-chemical indices of biological liquids in patients with a pathology of the pancreato-biliary system allows to objectively control the course of the disease and to correct the treatment methods.
Subject(s)
Bile/metabolism , Cholecystectomy , Cholecystitis/metabolism , Pancreatitis/metabolism , Adult , Aged , Carbohydrate Metabolism , Cholangitis/complications , Cholecystitis/complications , Cholecystitis/surgery , Cholecystitis/urine , Electric Conductivity , Electrolytes/metabolism , Female , Humans , Male , Middle Aged , Pancreatitis/complications , Pancreatitis/surgery , Pancreatitis/urine , Postoperative Period , Prognosis , Time Factors , Urine/chemistry , Water-Electrolyte BalanceSubject(s)
Infections/urine , Nitrogen/urine , Phenobarbital/pharmacology , Surgical Procedures, Operative , Acute Disease , Cholecystectomy , Cholecystitis/surgery , Cholecystitis/urine , Cholelithiasis/surgery , Female , Humans , Injections, Intravenous , Male , Phenobarbital/administration & dosage , Phenobarbital/blood , Postoperative Period , Time FactorsSubject(s)
Amino Acids/blood , Cholecystitis/metabolism , Cholecystokinin/urine , Trypsin Inhibitors/blood , Acute Disease , Adult , Aged , Cholecystitis/blood , Cholecystitis/urine , Female , Humans , Male , Middle AgedSubject(s)
Amylases/metabolism , Creatinine/metabolism , Creatinine/urine , Pancreatic Diseases/diagnosis , Amylases/blood , Amylases/urine , Cholecystitis/blood , Cholecystitis/urine , Creatinine/blood , Duodenal Ulcer/blood , Duodenal Ulcer/urine , Humans , Methods , Pancreatic Neoplasms/blood , Pancreatic Neoplasms/urine , Pancreatitis/blood , Pancreatitis/urine , Secretin/pharmacologyABSTRACT
The urinary excretion of corticosteroids (17-oxogenic steroids) and adrenal androgens (11-deoxy-17-oxosteroids) was studied in women below the age of 50 in a variety of clinical situations for comparison with a normal group. The conditions studied were: chronic debility from non-malignant disease, weight reduction, admission to hospital and surgery for varicose veins, hepatic non-malignant disease, and non-mammary cancer.The objective of the study was to determine whether the changes found in early and advanced breast cancer and used to judge the prognosis of the disease are specific to the disease or are merely incidental to the degree of illness caused by the disease.Similar changes to those found in breast cancer-principally a reduction in the excretion of the androgens-were found in the women with severe hepatic disease and in advanced non-mammary cancer. These were also found to follow the effects of severe surgical stress.It is concluded that the changes found in breast cancer are a measure of the general systemic disturbance caused by the disease and are not due specifically to it. Nevertheless, the value of their prognostic significance remains unchallenged.